Module 2 - Pneumonia Flashcards
Types of Pneumonia
Typical Atypical Hospital Acquired Pneumonia (HAI) Community Acquired Pneumonia (CAI) Ventilator Associated Pneumonia Aspiration Pneumonia Immunocompromised Pneumonia
Hospital Acquired Pneumonia
Pneumonia that develops >48 hours after admission into hospital
Community Acquired Pneumonia
Pneumonia that develops in the community or <48 hours after admission into hospital
Respiratory Defenses
Cough Reflex
Mucociliary Blanket
Respiratory macrophages
Respiratory antibodies
Signs & Symptoms of Typical Pneumonia
fever malaise chills fever productive cough - green/brown/yellow mucus SOB chest pain hemoptysis
Respiratory Defenses
Cough reflex
Mucociliary blanket
Antibodies (IgA)
Alveolar macrophages
Community-acquired Pneumonia
Pt has been out of hospital for 2 weeks
Diagnosis within 48 hrs of admission
Hospital-Acquired Pneumonia
Pt diagnosed after 48 hrs of admission
More likely to be associated with antibiotic-resistant bacteria
Aspiration Pneumonia
occurs when fluids/foreign matter is aspirated from upper airway –> lungs
Populations at risk for Aspiration Pneumonia
dysphagic patients
stroke patients
patients with decreased LOC (sedation, drugs, alcohol)
Walking Pneumonia
Mild case of CAP
does not require bedrest or hospitalization
Risk Factors
Surgery --> decreased DB+C Immobility Dysphagia Neurological/Cognitive impairment (stroke, dementia) Immunocompromised Alcohol Smoking Diabetes Heart Failure Age (>65) COPD
Complications of Pneumonia
hypoxemia life-threatening low blood pressure lung abscess lung injury -> acute respiratory distress syndrome sepsis
Consolidation
accumulation of fluid, debris and particles in the alveoli
Pneumonia
infection leading to inflammation of the lung parenchyma
Lobar Pneumonia
Entire lobe of lung is affected
Bronchopneumonia
patchy infection. part of the airway + parts of parenchyma are affected
Atypical Pneumonia Location
Affects the alveolar septum and interstitium of lungs
Typical Pneumonia Location
Affects the alveoli
Stages of Typical Pneumonia
Consolidation
Red Hepatization
Gray Hepatization
Resolution
SaO2
oxygen saturation of arterial blood. measured directly by an ABG or indirectly by pulse oximetry
SpO2
oxygen saturation of available hemoglobin in arterial blood. indirectly measures SaO2
PaO2
partial pressure of oxygen in blood plasma. measured by an ABG
Immunocompromised Pneumonia
microbes that may not cause pneumonia in healthy individuals cause pneumonia in IMC pts because of increased susceptibility
Atypical Pneumonia S/S
dry cough
low grade fever
Parenchyma
functional tissue of an organ
Typical Pneumonia Agents
bacteria
viral (influenza)
Atypical Pneumonia Agents
mycoplasma
viruses
Mycoplasma
type of bacteria lacking a cell wall
HA Pneumonia Risk Factors
Intubation/Venatilator Immunocompromised Status Chronic Lung Disease Immobility Dysphagia Airway instrument (endotracheal tube/tracheotomy)
Types of Immunocompromised Status
Low Humoral Immunity
Low cellular Immunit
Neutropenia/Impaired granulocyte function
Normal Lung Sounds
Bronchial
Bronchovesicular
Vesicular
Bronchial sounds
loc: trachea (abnormal if heard elsewhere)
loud
expiration
harsh, hollow, tubular
Bronchovesicular sounds
loc: major bronchi
moderate
heard on inspiration/expiration
mixed sound
Vesicular
loc: peripheral lung fields
soft
inspiration
rustling sound
Diagnostic Tests
ABG - acidosis CBC - elevated WBC Blood culture - bacteremia Chest X-ray - consolidation, edema Sputum Culture & Sensitivity (id bacteria & antibiotic)
Abnormal Respiratory Data
Chest pain Dyspnea Increased WOB Abnormal lung sounds SpO2 <92 or 88 Cyanosis Pale, cold, clammy (decreased CWMS)
Respiratory interventions (9)
Raise HOB DB+C Incentive spirometer Bronchodilators Oxygen therapy Fluid intake (dilute secretions) Pain treatment Oral care Promote Mobility
Determinants of gas exchange
Alveolar Diffusion Distance Ventilation Pulmonary Perfusion Composition of Air Gas Transport
Factors increasing metabolic demand
Physical Activity
Stress
Fever
